Preparedness and Perception on Virtual Learning during the COVID-19 Pandemic amongst Students of the Ekiti State University, Nigeria.

BACKGROUND: The advent of COVID-19 pandemic affected education which necessitated rapid adjustments and reorganizations in the approach to learning. This study examined undergraduate students' perception on the pandemic and its effect on medical education. METHODS AND MATERIALS: A cross-sectional online questionnaire-based survey of students in the College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria. A google form, free open-source software survey tool, was used to collect data on different domains like socio-demographic characteristics, preparedness and disposition to virtual learning in pandemic, risk perception, and knowledge on COVID-19. RESULTS: A total of 568 participants took the survey with 311 (54.8%) females and a median age of 20 (IQR: 18-22) years. Four hundred and eighty-two (84.9%) of the students had regular access to the Internet, 57 (10%) have occasional access while 29 (5.1%) had no access. Three hundred and fifteen (56%) of the students agreed that their digital and online skills will be better after the pandemic. All the students were aware of the pandemic however, 441 (77.6%) students were aware of the pandemic through the social media, 79 (13.9%) through television and newspapers and 32(5.6%) through family and friends while only 4 (0.7%) became aware of the pandemic through healthcare workers. The median risk perception score for COVID-19 was 24 (IQR: 19-29). CONCLUSION: The study participants were ill-disposed to virtual learning recommended during the pandemics and had a low-risk perception of COVID-19. Hence, there is an urgent need for continuous education on the benefits of virtual learning beyond the COVID-19 pandemics and the need to adopt proactive measures in anticipation of future outbreaks of other infectious diseases.

CONTEXTE: L'avènement de la pandémie de COVID-19 a été affecté l'éducation qui nécessitait des ajustements rapides et réorganisations de l'approche de l'apprentissage. Cette étude a examiné la perception des étudiants de premier cycle sur la pandémie et ses effets sur l'éducation médicale. MÉTHODES ET MATÉRIAUX: Une coupe transversale en ligne enquête par questionnaire auprès des étudiants du Collège des Médecine, Université d'État d'Ekiti, Ado-Ekiti, Nigéria. Un googleform, outil d'enquête gratuit en logiciel open source, a été utilisé pour collecter données sur différents domaines comme la sociodémographique caractéristiques, préparation et disposition à l'apprentissage virtuel dans la pandémie, la perception des risques et les connaissances sur la COVID-19. RÉSULTATS: Un total de 568 participants ont répondu à l'enquête avec 311(54,8 %) femmes et âge médian de 20 ans (IQR : 18-22 ans). Quatre cent quatre-vingt-deux (84,9 %) des élèves avaient desaccès à Internet, 57 (10 %) y ont accès occasionnellement alors qu'ils29 (5,1%) n'y avaient pas accès. Trois cent quinze (56 %) des étudiants ont convenu que leurs compétences numériques et en ligne seront mieux après la pandémie. Tous les étudiants étaient au courant de la pandemie toutefois, 441 (77,6 %) élèves étaient au courant de la pandémie par les médias sociaux, 79 (13,9 %) par l'intermédiaire de la télévision et les journaux et 32 (5,6 %) par l'entremise de la famille et amis alors que seulement 4 (0,7 %) ont pris conscience de la pandémiempar l'intermédiaire des travailleurs de la santé. Le score médian de perception du risque pour la COVID-19 était de 24 (IQR: 19-29). CONCLUSION: Les participants à l'étude étaient mal disposés à apprentissage virtuel recommandé pendant les pandémies et a eu un perception à faible risque de la COVID-19. Par conséquent, il y a une urgencebesoin de formation continue sur les avantages de l'apprentissage virtuel au-delà des pandémies de COVID-19 et de la nécessité d'adopter des mesures proactives en prévision de futures flambées d'autres maladies infectieuses. Mots-clés: COVID-19, préparation, étudiants, apprentissage virtuel, perception, Nigéria.

The acute effects of vinyasa flow yoga on vascular function, lipid and glucose concentrations, and mood.

While the chronic effects of certain styles of yoga on cardiometabolic factors have been investigated, little is known about the acute effects of a single yoga session on these outcomes. Moreover, vinyasa yoga's potential to modulate cardiometabolic outcomes has not been established. The purpose of this study is to determine the acute effects of a vinyasa yoga session on arterial stiffness, wave reflection, lipid and glucose concentrations, and mood in adults with prior yoga experience. Thirty yoga practitioners with a minimum of 3 months of practice experience were enrolled into the study. Carotid-femoral pulse wave velocity (cf-PWV), augmentation index (AIx), lipid profile, glucose concentrations, and mood (Positive and Negative Affect Scale) were assessed at baseline and immediately following a 1 -h vinyasa yoga session. After the yoga session, participants had significantly lower AIx (p < 0.001), non-HDL cholesterol (p < 0.05), and negative affect (p < 0.01) compared to baseline. These results highlight the efficacy of a single bout of yoga in altering wave reflection while improving mood and lipid concentrations in healthy adults with a history of yoga practice.

Normal CD4 Count Range among Healthy Nigerian Population in Ilorin.

BACKGROUND: For the establishment and monitoring of the immune status, CD4 count is critical. OBJECTIVES: To determine the CD4 count range of apparently healthy Nigerians resident in Ilorin and compare with the national value. METHODS: An automated blood analyzer was used to determine the full blood count and CD4 count. The percentage of CD4 count was derived by using other variables. RESULTS: Of the 1205 participants, the reference CD4 count (percentage of CD4) range for adult was 400 to 1288 cells/mm3 (19%-48%) and for children was 582 to 3652 cells/mm3 (17%-50%). CD4 count and percentage of CD4 were significantly ( P = .001) higher in females than in males, and the CD4 count declined significantly with increasing age ( r = -.174, P ≤ .0001). The percentage of CD4 count shows less variation with age ( r = -.051, P = .076). Adult residents of Ilorin had significantly lower absolute mean CD4 count (808 ± 260) than that of the national reference values of 847.0 ± 307.0 cells/mm3 ( P = .001). CONCLUSION: We therefore advocate the use of CD4 count range derived in this study is lower than that of the national reference values.

Prevalence and antibiotic susceptibility pattern of esbl producing klebsiellae isolated from clinical specimens in a nigerian tertiary hospital

Background: Infection by Extended Spectrum Beta Lactamases (ESBLs) producing bacteria is a threat to man as a consequence of treatment challenges. This study evaluated the prevalence and antimicrobial susceptibility pattern of ESBL producing Klebsiellae (EPK) in clinical specimens at the University of Ilorin Teaching hospital, Ilorin (UITH), Nigeria. Methods: ESBL production was assayed using Double Discs Synergy Test (DDST). Antimicrobial susceptibility was performed by Modified Kirby-Baeur method with the organism tested against ceftazidime (30µg), cefotaxime (30µg), amoxicillin clavulinic acid (20/10µg), cefepime (30µg), ciprofloxacin (5µg), gentamicin (10µg), trimethoprim-sulphamethoxazole (23.75/1.25µg), imipenem (10µg) and doripenem (10µg) (Oxoid, UK). Results: Fifty (26.7%) of the 187 Klebsiellae studied were EPK comprising of 37(26.8%) Klebsiella pneumoniae and 13(26.5%) Klebsiella oxytoca. EPK were mostly from wound specimens (24.0%) although Klebsiellae were mostly occurring in sputum (26.2%). The EPK were resistant to ceftazidime (100%), cefotaxime (94.0%), trimethoprim-sulphamethoxazole (92.0%), gentamicin (70.0%) and ciprofloxacin (70.0%) but 100% susceptible to both doripenem and imipenem. Conclusion: The prevalence of EPK in this study is high and they are multi-drug resistant. Carbapenems are the best antibiotic treatment option for infections arising from these organisms although a coordinated rational usage is desired along with functional antibiotic prescription policy to avoid treatment failures. Continuous surveillance for ESBL producing Klebsiellae and resistance monitoring are necessary routine to strengthen infection control policies

Measles vaccine potency and sero-conversion rates among infants receiving measles immunization in Ilorin, Kwara State, Nigeria.

This study was designed to assess the seroconversion rate of measles vaccine among infants receiving measles immunization in Ilorin, Nigeria. The pre- and post-measles vaccination sera of the children were tested using the Haemagglutination Inhibition test. The measles vaccines administered at the immunization centre were also tested for their potency using in-vitro titration method. Only 286 (71.5%) of the vacinees returned to give post-vaccination samples. All the infants screened had low pre-vaccination measles antibody titers. Thirty one (8.0%) of the infants had measles prior to vaccination. The seroconversion pattern showed that 196 (68.6%) of the infants developed protective antibody titers. Low seroconversion rate reported in this study was due to low vaccine potency. The titers of vaccines with low potency ranged between log10(-1.0)-log10(-2.25) TCID/per dose. This was beside other non specific antiviral substances exhibited virus neutralizing activity. Only 3 (50%) of the 6 vaccine vials tested had virus titers of log10(-3.25) to log10(-3.5), which fell above the cut-off point recommended by the World Health Organization for measles vaccines. The sero-conversion rate of 68.6% observed among vaccinees is far lower than the immunity level of 95% required stopping measles transmission in an endemic community. Failure of 31.4% of these infants to sero-convert post vaccination can be attributed partly to administration of sub-potent vaccines. There is need for improvement and maintenance of effective vaccine cold chain system in Nigeria. There is need also for periodic monitoring of post-vaccination antibody titers as well as vaccine potency status in order to ensure development of protective seroconversion rates.

Prevalence of Extended Spectrum beta-Lactamase-Producing Klebsiella Species at the University of Ilorin Teaching Hospital

Background: Persistent blind antibiotic treatment of patients; in resource poor nations like Nigeria; makes the prevalence of antibiotic resistance to increase sporadically. Extended spectrum beta-lactamase (ESBL) production is one of the ways by which bacteria become resistant to antibiotics. For this reason; isolation; identification; sensitivity and screening for possible resistance genes is very important before prescription; if the affected patients must receive qualitative care particularly when their condition is chronic. Materials and Methods: Four hundred suspected isolates of Klebsiella belonging to various species obtained from routine specimens such as swabs; urine; blood; and sputum from May to October 2009 were studied. The identity of all isolates obtained was biochemically analyzed. The isolates were subjected to antibiotic susceptibility testing using modified Kirby-Bauer method and ESBL production was phenotypically determined using double disc synergy test for laboratory detection and reporting of bacteria by CLSI method. Results: Ninety-eight (24.5%) isolates expressed ESBL. Majority of the ESBL producing isolates were from swab specimens 59 (14.75%) followed by blood culture 16 (4.0%); urine 13 (3.25%); and sputum 10 (2.5%). Sensitivity patterns of ESBL producing Klebsiella spp. revealed that all ware resistant to augmentin (AUG); ceftazidime (CAZ); cefotaxime (CTX); cefuroxime (CRO); cefpodoxime (CPD); and none resistant to imipenem (IMP).Conclusion: ESBL producing Klebsiella spp.; were present in University of Ilorin Teaching Hospital. They are resistant to augmentin (AUG); CAZ; CTX; and CPD. Presence of ESBL in any Klebsiella spp. has made cephalosporins which are first line antibiotics usually given non-effective; thereby reducing the treatment options. We; therefore; suggest screening and confirmation for ESBL; in other to prevent treatment failure

Sero-prevalence of syphilis among patients with mental illness: comparison with blood donors.

BACKGROUND: Mentally ill individuals (MII) are at risk of acquiring syphilis and other sexually transmitted infections. This study aimed at determining sero-prevalence of syphilis among MII and compare them with voluntary blood donors (VBD) at University of Ilorin Teaching Hospital (UITH), Nigeria. METHODS: A cross-sectional study done between June, 2010 and June 2011, and involving 350 each of VBDs and MII in and out-patients of UITH. Serological test was done using venereal disease research laboratory (VDRL) and the Treponema Pallidum Haemagglutination (TPHA) kit. RESULTS: Of the 700 subjects, 324 (92.6%) MII, and 349 (99.7%) VBDs were <55 years; 71 (21.4%) MII were Civil Servants compared with 96 (27.4%) VBDs. Significantly more VBDs had higher education than MII (185 or 52.9%, and 140 or 40% respectively). Christians constituted the majority (176 or 50.3%) among MII, and Muslims (210 or 60%) among VBDs. Significantly more married VBDs (204/206 or 99.0%) live with spouses; more VBDs consumed alcohol (37 or 10.6%), smoked (19 or 5.4%), and engaged in extramarital sex (105 or 30.0%). Significantly more MII had blood transfusion (40 or 11.4); engaged in sex trade (12 or 3.4%); and more syphilis prevalence (5.4%). In addition, more syphilitic MII smoked (18 or 94.7%); and all syphilitic MII had psychotic disorders. CONCLUSION: The prevalence of syphilis in MII is significantly higher than among VBDs. Routine screening of MII is advocated to stem this problem.

Bacteriological agents of chronic discharging ears and their antibiotic sensitivity pattern in Ido - Ekiti, Nigeria.

AIMS AND OBJECTIVES: To identify bacterial agents of chronic discharging ear and determine their antibiotic sensitivities pattern in Ido - Ekiti, Nigeria. PATIENTS AND METHODS: Swab specimens of each chronically (>8 weeks) discharging ears of patients with chronic suppurative otitis media (CSOM) presenting to the Ear, Nose and Throat (ENT) clinic of the Federal Medical Centre, Ido Ekiti were bacteriologically cultured aerobically and the antibiotic sensitivity pattern of the recovered organisms determined by the modified Kirby-Bauer disc-diffusion method over a three year period starting from January 2005. RESULTS: Seventy eight patients with CSOM whose age ranged between 3 months and 85 years were seen during the study period with 73.1% of them having unilateral disease and majority were children < 15 years (71.8%). Out of 99 ear swabs that were examined, 87.9% were culture positive with 90.8% yielding a single isolate. Coliforms (34.7%) were the most frequent isolated group of organisms. Other isolates included Staphylococcus aureus (26.3%), Proteus spp (24.2%), Pseudomonas spp (9.5%) and Klebsiella spp (5.3%). Sparfloxacin and ciprofloxacin showed highest activity on all the isolates unlike cefuroxime and ceftiaxone to which all isolates were resistant. CONCLUSION: Chronic discharging ear is caused by bacteria agents most sensitive to quinolones but resistant to cefuroxime and ceftiaxone. Treatment of patients with CSOM in Ido-Ekiti with the quinolones is recommended except where contraindicated.

Awareness and practice of safety precautions among healthcare workers in the laboratories of two public health facilities in Nigeria.

AIMS AND OBJECTIVES: To determine the level of awareness and practice of SP among laboratory workers at two tertiary public health facilities in Nigeria. METHODS: A semi-structured, self-administered questionnaire was used to assess the awareness, attitude and adherence to SP among laboratory workers. Information on the availability of safety equipment was also sought. The laboratory safety practice of respondents was assessed based on self-reported observance of basic principles of universal precautions in clinical settings. RESULTS: Study participants were 130, mean age: 28.2 years (SD±6.6), number of years in hospital employment: 3.7 years (SD±2.4) and the male to female ratio was 1.8:1. Many (41.5%) were unaware and 25.4% do not observe SP. Participants attest to availability of various safety devices and equipment including hand gloves (86.2%), disinfectants (84.6%), HBV immunisation (46.2%) and post exposure prophylaxis (PEP) for HIV and HBV (79.6%). Attitude to safety is unsatisfactory as 60.0% eat and drink in the laboratory, 50.8% recap needles and 56.9% use sharps box. Even though 83.1% are willing to take PEP, only 1.5% will present self following laboratory injury. CONCLUSION: This study shows the deficit in the awareness of SP among laboratory personnel and demonstrates that attitude and practice of safety rules are unsatisfactory. Training and re-training on SP is therefore desired. Counselling to induce a positive attitudinal change on HBV immunisation and PEP is similarly necessary.

Methicillin resistant Staphylococcus aureus: awareness, knowledge and disposition to screening among healthcare workers in critical care units of a Nigerian hospital.

BACKGROUND: Awareness level about methicillin resistant Staphylococcus aureus (MRSA) is high in the western world but the status in developing countries is not well defined. OBJECTIVE: To assess MRSA awareness level, knowledge and disposition to screening among critical healthcare givers (HCGs) in Nigeria. METHODS: A self-administered questionnaire was used to assess the level of awareness and knowledge of HCGs in critical care units of the University of Ilorin Teaching Hospital, Ilorin, Nigeria on MRSA and their willingness to submit to screening. RESULTS: Only 103 (52.0%) of the 198 participants were aware of MRSA but all were favourably disposed to screening for the organism. Awareness was through hospital rounds 65(63.1%) and journals/ textbooks 35(34.0%), and Many, 120 (60.6%) considered MRSA as a threat in the hospital, while only 27 (13.6%) thought otherwise and 51(25.8%) were indifferent. Most HCGs, 124 (87.9%) reported that there were no MRSA control measures in their respective duty post. The age, cadre of work, and number of years in the hospital's critical care units correlated positively with awareness level. CONCLUSION: Methicillin resistant Staphylococcus aureus awareness level among the HCGs in our hospital is just a little above 50.0% with substantial proportion of them not realizing the medical implication of the organism. However, majority are well disposed to MRSA screening. Inadequate publicity is a major contributor to poor knowledge and awareness. There is need for educational intervention and sensitization programs on MRSA and other infection control techniques for HCGs in developing nations especially Nigeria.

Status disclosure among People Living with HIV/AIDS in Ilorin, Nigeria.

BACKGROUND: HIV/AIDS is a disease that is characterised by discrimination and stigmatisation particularly in Africa. OBJECTIVE: To determine rate of disclosure of HIV status among People Living with HIV/AIDS (PLWHA) in Ilorin, Nigeria. METHODS: A semi-structured, interviewer administered questionnaire containing 40 items was used to collect information from persons living with HIV/AIDS accessing treatment at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Information on patients' socio-demography and life-style history, HIV medical history and HIV status disclosure was obtained from the patients. RESULTS: A total of 253 patients participated in the study. Their ages ranged between 26 and 58 years. Majority were females, 58.5% and 41.5% were males. The disclosure rate was 39.5%. As many as 60.5% of the respondents had not disclosed their HIV status to anybody. The disclosure was to the spouses, in 18.6% of the instances and to relatives or friends or co workers in another 20.6% of cases. There was a significant difference. The knowledge of their spouses on HIV/AIDS status correlated with disclosure rate, r=0.237, p=0.02. Female sex, intact family and monogamy correlated well with high disclosure rate. CONCLUSION: HIV status disclosure rate among PLWHA in Ilorin is low. Female sex and monogamous marital status are positive predictors of disclosure. There is need to ensure effective disclosure counselling for the unmarried; single/ separated, patients in polygamous marriages and males member of the society.

Influence of performance status on the risk and outcome of nosocomial pneumonia in the elderly admitted to an open medical ward.

BACKGROUND: nosocomial pneumonia (NP) has been observed to complicate the course of management of some elderly patients in medical wards and this impacts negatively on the outcome of care of this group of patients. OBJECTIVE: to determine the relationship of pre-treatment performance status (PTPS) on the risk and outcome of NP in elderly patients admitted to an open medical ward. METHODS: a prospective clinical surveillance of all elderly patients admitted to the medical wards of a University Teaching Hospital was carried out over a period of nine years. RESULTS: in the nine-year period 531 patients; aged 65 to 107 years were seen, 184(34.7%) of whom developed NP. Eleven (21%) patients had PTPS of 75% or more (i.e. able to care for selves without assistance), one (0.2%) of whom developed NP. Seventy-eight (14.7%) patients had PTPS of 51-74% (i.e. required occasional assistance for routine care); 13(2.4%) of whom also developed NP. Of the 217 (40.9%) patients who had PTPS of 26-50% (i.e. requiring considerable assistance for self care), 73(13.7%) of them had NP while 97 (18.3%) out of 225 patients with PTPS below 25% (i.e. completely dependent on others for routine care) developed nosocomial pneumonia. CONCLUSION: a low performance status score increases the risk of development of NP in the elderly and this risk is influenced by type of treatment-related interventions a patient has on admission.

Mortality pattern within twenty-four hours of emergency paediatric admission in a resource-poor nation health facility.

BACKGROUND: Mortality among emergency paediatric admissions within the first 24 hours is high in resource- poor nations. Measures to reduce the childhood mortality rate can only be effectively planned and implemented when the causes and magnitude of this problem are well defined. OBJECTIVE: To determine the mortality pattern among emergency paediatric admissions within the first 24 hours in a health facility in Nigeria. METHODS: The clinical state and progress of post-neonatal patients who presented alive and were admitted into the emergency paediatric room of the University of Ilorin Teaching Hospital, Ilorin, Nigeria were monitored over a period of six months. The monitoring included records of diagnosis and outcome of management. RESULTS: A total of 606 children were admitted during the period of study out of which 51(8.4%) died. Twenty-nine (57%) of the deaths occurred within the first 24 hours of admission comprising 15 (51.7%) males and 14 (48.3%) females giving M:F ratio of about of 1:1. Majority of the deaths were among patients who reported late to the hospital. Loss of consciousness was a strong risk factor for mortality within 24 hours of admission. The highest mortality within the first 24 hours of admission was recorded among patients with malaria (89.0%) followed by protein energy malnutrition. CONCLUSION: Majority of deaths among emergency paediatric admission occur within the first 24 hours of admission and are associated with clinical conditions such as malaria and protein-energy malnutrition for which sustained intervention strategies must be developed.

Haemophilus meningitis in an African neonate: time for active surveillance and institution of appropriate control measure.

BACKGROUND: Childhood routine immunization in Nigeria, like most developing nations, do not include vaccination against Haemophilus influenzae type b (Hib) infection. This is probably because infection with Hib is uncommon in children younger than two months due to passive acquisition of maternal antibodies which protects newborn till about four to six months of life. OBJECTIVE: To illustrate a case of neonatal meningitis caused by Haemophilus influenzae and to highlight its other peculiarities. METHODS: A 22-day old baby presented with excessive crying, refusal of feed, progressive abdominal distension, fever and vomiting. Besides clinical assessment, body fluids were cultured. RESULTS: The baby had tachypnoea (90 bpm), tachycardia (182 bpm), and tympanitic and hypoactive abdomen. The musculoskeletal and central nervous systems appeared clinically normal. Haemophilus influenzae was isolated by culture from the cerebrospinal fluid. The baby responded well to treatment with ceftriaxone and gentamycin. Neurological examination has remained normal after discharge for up to three months at follow-up visit. CONCLUSION: There is the need to provide serological and molecular facilities for typing Nigerian Haemophilus infulenzae strain(s) to enhance the development of appropriate vaccine that will be most suitable for prevention of infection due to this organism in Nigeria. However, presently available Haemophilus influenzae vaccine needs to be listed in the National Programme for Immunization (NPI) for the control of infections associated with this organism especially in childhood.

The reported preparedness and disposition by students in a Nigerian university towards the use of information technology for medical education.

BACKGROUND: The computer and information technology (IT) revolution have transformed modern health care systems in the areas of communication, storage, retrieval of medical information and teaching, but little is known about IT skill and use in most developing nations. OBJECTIVES: The aim of this study has been to evaluate the reported preparedness and disposition by medical students in a Nigerian university toward the use of IT for medical education. METHODS: A self-administered structured questionnaire containing 24 items was used to obtain information from medical students in the University of Ilorin, Nigeria on their level of computer usage, knowledge of computer software and hardware, availability and access to computer, possession of personal computer and e-mail address, preferred method of medical education and the use of computer as a supplement to medical education. RESULTS: Out of 479 medical students, 179 (37.4%) had basic computer skills, 209 (43.6%) had intermediate skills and 58(12.1%) had advanced computer skills. Three hundred and thirty (68.9%) have access to computer and 451(94.2%) have e-mail addresses. For medical teaching, majority (83.09%), preferred live lecture, 56.78% lecture videos, 35.1% lecture handout on web site and 410 (85.6%) wants computer as a supplement to live lectures. Less than half (39.5%) wants laptop acquisition to be mandatory. Students with advanced computer skills were well prepared and disposed to IT than those with basic computer skill. CONCLUSION: The findings revealed that the medical students with advanced computer skills were well prepared and disposed to IT based medical education. Therefore, high level of computer skill is required for them to be prepared and favorably disposed to IT based medical education.

Epidemiology, etiology, and treatment of chronic leg ulcer: experience with sixty patients.

BACKGROUND: Chronic leg ulcer (CLU) is reported to have an impact on virtually all aspects of life. Treatment is expensive and has large economic burden on many countries' health services. This presentation is to determine the impact, etiology, and presentation of CLU as well as the procedures for processing in a Nigeria tertiary care facility. METHODS: All patients with CLU seen that were prospectively managed in our hospital between 2004 and 2006 have been included in the study. The data were analyzed by SPSS version 11.0 of software. RESULTS: Sixty consecutive patients seen over a period of 3 years (2004-2006) were prospectively studied. There were two peak period of age presentation 30-39 and 50-69 years. The male female ratio was 1:1. Most of the patients (93.3%) had unilateral ulcers and it was as common on the right as on the left. Fifty percent of patients had medical disorders. The commonest cause of CLU was poorly managed traumatic wound. CONCLUSION: Most patients benefited from debridement with or without split thickness skin graft or flap.

Mortality pattern within twenty-four hours of emergency paediatric admission in a resource-poor nation health facility

BACKGROUND: Mortality among emergency paediatric admissions within the first 24 hours is high in resource- poor nations. Measures to reduce the childhood mortality rate can only be effectively planned and implemented when the causes and magnitude of this problem are well defined. OBJECTIVE: To determine the mortality pattern among emergency paediatric admissions within the first 24 hours in a health facility in Nigeria. METHODS: The clinical state and progress of post-neonatal patients who presented alive and were admitted into the emergency paediatric room of the University of Ilorin Teaching Hospital; Ilorin; Nigeria were monitored over a period of six months. The monitoring included records of diagnosis and outcome of management. RESULTS: A total of 606 children were admitted during the period of study out of which 51(8.4) died. Twenty-nine (57) of the deaths occurred within the first 24 hours of admission comprising 15 (51.7) males and 14 (48.3) females giving M:F ratio of about of 1:1. Majority of the deaths were among patients who reported late to the hospital. Loss of consciousness was a strong risk factor for mortality within 24 hours of admission. The highest mortality within the first 24 hours of admission was recorded among patients with malaria (89.0) followed by protein energy malnutrition. CONCLUSION: Majority of deaths among emergency paediatric admission occur within the first 24 hours of admission and are associated with clinical conditions such as malaria and protein-energy malnutrition for which sustained intervention strategies must be developed

Epidemiology, etiology, and treatment of chronic leg ulcer: experience with sixty patients

Background: Chronic leg ulcer (CLU) is reported to have an impact on virtually all aspects of life. Treatment is expensive and has large economic burden on many countries' health services. This presentation is to determine the impact; etiology; and presentation of CLU as well as the procedures for processing in a Nigeria tertiary care facility. Methods: All patients with CLU seen that were prospectively managed in our hospital between 2004 and 2006 have been included in the study. The data were analyzed by SPSS version 11.0 of software. Results: Sixty consecutive patients seen over a period of 3 years (2004-2006) were prospectively studied. There were two peak period of age presentation 30-39 and 50-69 years. The male female ratio was 1:1. Most of the patients (93.3) had unilateral ulcers and it was as common on the right as on the left. Fifty percent of patients had medical disorders. The commonest cause of CLU was poorly managed traumatic wound. Conclusion: Most patients benefited from debridement with or without split thickness skin graft or flap

Cryptococcal meningitis in a newly diagnosed AIDS patient: a case report.

BACKGROUND: Cryptococcus neoformans is a very important cause of fungal meningitis in immunosuppressed patients OBJECTIVE: To describe a case of cryptococcal meningoencephalitis in an HIV/AIDS patient from the University of Ilorin Teaching Hospital. METHODS: An 18 -year -old male student presented with cough, weight loss, and fever. He was clinically assessed and had full laboratory investigations including cerebrospinal fluid CSF and then started on chemotherapy. Both the clinical and neurological evaluation of the patient was described along with the laboratory analyses of his CSF. Outcome of how he was managed was also reported. RESULTS: Cryptococcus neoformans presented as an AIDS defining fungal infection for the first time in this 18 year old undergraduate who was infected probably from transfusion of unscreened blood He had advanced HIV infection (CD4+ count of 29 cells/ul) and severe cryptococcal meningoencephalitis. He was unsuccessfully managed with fluconazole, a second choice drug for this condition, amphotericin B being not available. CONCLUSION: Nigerians should have access to effective blood transfusion services at all public and private hospitals across the country. The National Essential Drug list should be expanded to include drugs such as amphotericin B which hitherto were considered exotic.

Bacteriological Pattern of Wound Swab Isolates in Patients with Chronic Leg Ulcer

Purpose: To determine the pattern of bacterial pathogens and their antibiotic sensitivity profile in patients with infected chronic leg ulceration. Methods: Sixty swab specimens obtained from chronic leg ulcer (CLU) patients were cultured aerobically and the antibiotic sensitivity pattern of the recovered organisms determined by the modified Kirby -Bauer disc-diffusion method. Results: 47 (78.3) of the ulcers were infected out of which 39 (83.0) were culture positive. Most of the culture positive ulcers were on the distal third of the leg. The isolated bacteria from the wounds were Pseudomonas aeruginosa (33); Staphylococcus aureus (24); Proteus spp (15); Klebsiella spp (13); Citrobacter spp (13) and Escherichia coli (2). None of the patient without clinical evidence of wound infection had bacterial positive wound swab culture. All isolates were sensitive to third generation cephalosporin and floroquinolones but majority were resistant to ampicillin. Conclusion: Pseudomonas aeruginosa; Staphyloco-ccus aureus. Proteus spp; Klebsiella spp; Citrobacter spp and Escherichia coli sensitive to third generation cephalosporin and floroquinolones have been recovered from 78of patients with chronic leg ulcers in a tertiary health facility in Nigeria